Drug & supplement interaction

Gamboge + Trichlormethiazide

Trichlormethiazide brand names: Metahydrin, Naqua, Marazide II, Aq 4B Aquazide.

Moderate Interaction
The bottom line Moderate

Gamboge has a moderate interaction with Trichlormethiazide. Overuse of gamboge might compound diuretic-induced potassium loss.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Gamboge and Trichlormethiazide

Here is the interaction we found between these two, with the evidence behind it.

Moderate

DIURETIC DRUGS

Why this applies to Trichlormethiazide

Trichlormethiazide falls under DIURETIC DRUGS — the group Gamboge interacts with.

Overuse of gamboge might compound diuretic-induced potassium loss. There is some concern that people taking gamboge along with potassium depleting diuretics might have an increased risk for hypokalemia. Initiation of potassium supplementation or an increase in potassium supplement dose may be necessary for some patients.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with these two together. Trichlormethiazide is a thiazide-type water pill, and like most diuretics in its family, it tends to flush potassium out of your body. Gamboge, when used as a harsh laxative, can also drain potassium and fluids through the gut. Stack them up and your potassium could dip too low, a state called hypokalemia.

Low potassium isn't something to brush off. It can cause muscle weakness, cramps, fatigue, and in some cases an irregular heartbeat. To be clear, this warning is theoretical, based on how each substance works rather than reported cases. Honestly, my bigger worry is that gamboge itself is toxic even in small amounts, so I'd steer clear of taking it at all. Please check in with your pharmacist or doctor before combining anything with your diuretic.

References
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Gamboge Also Interacts With Other Medications

Gamboge has 121 moderate known drug interactions in our database — the Trichlormethiazide one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Gamboge

Covers the 2,830 medications we’ve checked against Gamboge. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Trichlormethiazide

This page covers Gamboge only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Trichlormethiazide page lists 227 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Asarabacca (major) and Dolomite (major).

By severity: 10 major · 192 moderate · 25 minor.

Open the Trichlormethiazide interaction page

How much people look this up

Where Gamboge and Trichlormethiazide Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Gamboge
Steady interest

#754 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Trichlormethiazide
Top half

#958 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Gamboge

What is Gamboge?

  • Laxative (purgative)
  • Expelling intestinal worms
  • Traditional wound care
  • Use as a yellow dye/pigment

Gamboge is a bright yellow tree resin used historically as a strong laxative and as an artists' pigment, but it is toxic in even modest amounts and is not a safe dietary supplement. Modern interest centers on its compound gambogic acid in laboratory cancer research, which does not make the raw resin safe to take. We recommend avoiding oral use of gamboge.

Read the full Gamboge monograph & all interactions
Keep checking

Other Drugs & Gamboge

Browse every other medication we’ve checked against Gamboge — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
121Moderate
0Minor
2,708No known interaction
Moderate

121 interactions

Showing 60 of 121 moderate interactions — see all 121 on the Gamboge page.

No interaction 2,708 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Gamboge and Trichlormethiazide Together: Common Questions

Can you take Gamboge with Trichlormethiazide?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Gamboge and Trichlormethiazide interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.